| NPI | 1598183766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2019-0507) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 333879) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME158850) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.146187) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 59016) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2022-12-06 |