| NPI | 1225215627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A94633) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61438096) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX U5352) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-17253) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 13417074-1205) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MT 127164) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD21615) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 0071036) | |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2025-03-13 |