| NPI | 1689622094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO CDRH.0056669) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35-090435) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036093080) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME143093) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2020-05-21 |