| NPI | 1972800282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD22755) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME111863) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 30036) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 49955) | |
| Enumeration Date | 2011-02-22 |
| Last Update Date | 2019-06-05 |