| NPI | 1679656219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 49145) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 54378) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL TRN9097) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R2220) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 25773) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-36782) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD17560) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2024-03-31 |