| NPI | 1962447292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2005031944) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M5511) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 033649) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0431662) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-8625) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 30375) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2023-06-21 |