| NPI | 1255478525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD167598) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 47811) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-12299) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 7855) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60145573) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2021-02-23 |