| NPI | 1144234436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX TM00501) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 060949) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2007-01456) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 251301) | |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2017-03-09 |