| NPI | 1447282975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX m9299) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 227179) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 248670) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 061074) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A105205) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2012-01-20 |