| NPI | 1982674628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0068367) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WY TL7304) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 34615) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD203118) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2022-07-27 |