| NPI | 1477514297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 27853) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 33279) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2010-00805) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 53606) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD.205960) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 9548A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P6142) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101246268) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2021-04-01 |