| NPI | 1003163684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.122058) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD046727) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0083651) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A155786) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101270800) | |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2023-01-24 |