| NPI | 1467435586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 223567) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY TP261) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01060831A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.087028) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2007-07-08 |