| NPI | 1316942386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 36159) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 24101) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DC ME140637) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 301341) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 27218) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G163088) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 83578) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC MD82862) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 64049) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.136633) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 320982) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD468633) | |
| 174400000X Specialist (Licence: AL 24101) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101266336) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 29251) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2025-09-29 |