| NPI | 1467609438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX S0212) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60743946) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME115200) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 73375) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 55602) | |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2024-05-23 |