NPI | 1104856145 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301056038) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME117258) |
2085R0202X Radiology, Diagnostic Radiology (Licence: GA 069045) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01071636A) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD045429E) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35-058853) | |
Enumeration Date | 2006-07-04 |
Last Update Date | 2021-08-16 |