| NPI | 1497726129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2020013312) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: MO 2020013312) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036134690) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01058395A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35121049) | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2020-07-14 |