| NPI | 1952527012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 35124) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q0756) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GU EMTL-2022-034) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GU M-2359) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-02-15 |