| NPI | 1275581076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 20963) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY TP199) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.087295) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01061747A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 36114676) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2007-07-19 |