| NPI | 1538458005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2017-00888) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 54590) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101265858) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD045027) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX 52573) | |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2024-09-10 |