| NPI | 1376591503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35078074) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA IMLC.MD.70126213) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25IA13110700) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01100066A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301087108) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: FL ME181504) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 29420) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 77732) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX W6120) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036180075) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2026-02480) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2026-05-22 |