| NPI | 1598984254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 44660) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY R0935) |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: CA A 106825) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N6454) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: KY 44660) | |
| 2085B0100X Radiology, Body Imaging (Licence: KY 44660) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2012-12-19 |