| NPI | 1972586998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 41313) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: CO 41313) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD21083) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-43715) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 26933) | |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2022-12-12 |