| NPI | 1235187519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 209414) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM TM2005-0451) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 23295) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 39867) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME94981) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 0106123A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SD 5815) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2005-01209) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2010-03-30 |