| NPI | 1518393768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX S2716) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 54213) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D82398) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 285728) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 65883) | |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2024-09-10 |