| NPI | 1902031925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0055072) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 28485) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 10132A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101256540) | |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2015-08-20 |