| NPI | 1972551315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 72481) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 35408) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 43213) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 41449) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2021-03-30 |