| NPI | 1912987942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 11282) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME145331) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 9900166) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A89898) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2021-07-12 |