| NPI | 1255318036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G50834) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 5855) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 35464) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 30786) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA07189700) | |
| 207K00000X Allergy & Immunology (Licence: IL 036.103835) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2010-06-01 |