| NPI | 1871548818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TN 41111) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: LA 024282) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0601236324) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MS 29913) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2022-03-11 |