| NPI | 1639168875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 31164) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 101235754) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME89882) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 53932) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 38530) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 61623) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD423244) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 21433) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 31886) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: NC 31164) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: KY 38530) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: SC 31886) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2015-05-01 |