| NPI | 1144548975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 58032) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-39663) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 331958) | |
| 2085N0700X (Licence: WA MD60547959) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 29821) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R1731) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 55544) | |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2022-08-10 |