| NPI | 1871793380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 14108) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A120796) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD209731) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M8921) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2023-03-02 |