| NPI | 1902224017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS18037) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 82627) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0063511) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 12726A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 2148) | |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2025-10-03 |