| NPI | 1972517084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C146904) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2006-00956) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 44164) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00048041) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME104259) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-03-07 |