| NPI | 1922083401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 37502) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-36271) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI 17549) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 54296) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 24987) | |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2022-12-12 |