| NPI | 1265654164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036121833) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 231276) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 29333) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 14221R) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 200700577) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08392500) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 59785) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2008-09-16 |