| NPI | 1447302591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO 61745) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: TX M9190) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: UT 10684133-1205) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: OK 23227) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: HI MD20472) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-42027) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NE 31572) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2022-12-13 |