| NPI | 1154438315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 22682) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35089226) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 052617) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 40841) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2024-05-07 |