| NPI | 1447431796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 286699) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR0046679) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P4704) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 146459) | |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2019-06-01 |