| NPI | 1902119654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD442592) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: DE C7-0004488) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA C54610) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: PA MT189906) | |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2024-10-24 |