| NPI | 1891040689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0058120) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GU MC-163) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 28626) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 15272) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 11892C) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2018029416) | |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2025-09-23 |