| NPI | 1194016659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IA MD-50032) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036160751) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: TX R1815) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KY C3945) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: AL 51244) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NV 27506) | |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2025-05-19 |