| NPI | 1205818127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL 60421) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AR E-4403) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: TX L4691) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 37100) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MI 4301507775) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101235012) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2024-03-19 |