| NPI | 1972675817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 14066) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 33773) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-9680) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C22730) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2007-07-08 |