| NPI | 1144218108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: HI MD-13504) |
| Additional Taxonomies | 2085N0700X (Licence: CO DR.0061765) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0061765) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD-13504) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME161415) | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2024-09-05 |