| NPI | 1255484283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA OP00002105) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-14110) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 57331) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 4156) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 009515) | |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2024-05-16 |