| NPI | 1982600235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 28038) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 072272) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME121175) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 49132) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2017-12-20 |