| NPI | 1407893738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 228309) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME164193) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GU MC-155) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-51377) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2024-10-14 |