| NPI | 1396716577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD044488E) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.078278) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01076566A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 47828) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101265007) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301108969) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2019-11-06 |