| NPI | 1487782033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N7659) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX FTL 42178) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX FTL 42587) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX FTL 41676) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME137237) | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2021-03-11 |