| NPI | 1285623280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 71917) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 23301) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 1461651) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 038187) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ME 015335) | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2007-07-08 |