| NPI | 1154326049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35-0821270) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME91698) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 024530) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301079195) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 38759) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 151198) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD032390E) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2012-04-24 |