| NPI | 1891895348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P6212) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2003008575) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A97749) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 15510) | |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2021-02-09 |