| NPI | 1457332447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N1178) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME106631) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01046242) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 251471) | |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2024-02-08 |