| NPI | 1295759496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN MD0000039320) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO R7644) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 36743) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 42244-20) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 057385) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301086983) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2016-03-24 |