| NPI | 1891112264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC 5289444) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0065471) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 72496) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD-22367) | |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2024-09-26 |