| NPI | 1417912684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G88603) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD062393L) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 26046) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA07614200) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2020-03-11 |