| NPI | 1376761916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101-233524) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 50850) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.132646) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD462820) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301113780) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2023-04-06 |