| NPI | 1033226154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 02000572A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 34002606) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 32745) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 43169) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 3070) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NM A-1313-05) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2007-07-08 |