| NPI | 1861889909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 74869) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 72289) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD-23870) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA12003700) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-17247) | |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2024-11-18 |