| NPI | 1881628808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO CDRH.0046627) |
| Additional Taxonomies | 2085D0003X Radiology Diagnostic Neuroimaging (Licence: CO DR-46627) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA A95335) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NC 200501907) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 41009) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2022-09-20 |