| NPI | 1669510947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35043301) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 134472) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301052451) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD042621E) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA05681100) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 6740) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036077263) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2008-06-11 |