| NPI | 1144204959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.135596) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD13970) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME 39230) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00043797) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0031499) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA O101042041) | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2020-08-24 |