| NPI | 1689606238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 34001528L) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 03610016) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IN 02002173A) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 529537) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KY 02734) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MI 5101016720) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MD H0058263) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: WI 43569021) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2007-07-08 |