| NPI | 1053510727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101268249) |
| Additional Taxonomies | 2085N0700X (Licence: PA MD445133) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 81578) | |
| 2085N0700X (Licence: CO DR.0073896) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD445133) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME140676) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09506600) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301503412) | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2024-11-07 |