| NPI | 1669440509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 182021) |
| Additional Taxonomies | 2085N0700X (Licence: IN 01064502A) |
| 2085N0700X (Licence: FL ME97617) | |
| 2085N0700X (Licence: GA 58555) | |
| 2085N0700X (Licence: CO DR-45087) | |
| 2085N0700X (Licence: TN 41168) | |
| 2085N0700X (Licence: NC 2007-01971) | |
| 2085N0700X (Licence: MS 19813) | |
| 2085N0700X (Licence: TX TM00086) | |
| 2085N0700X (Licence: IL 036-117102) | |
| 2085N0700X (Licence: NM TM2006-0470) | |
| 2085N0700X (Licence: ID M-10716) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2020-01-13 |