| NPI | 1558896894 |
|---|---|
| Former Name | JUSTIN BRENT THURMAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2023025238) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 2023025238) |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2023-07-12 |