| NPI | 1689659039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO R1H83) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036079642) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 37086) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 25729) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101241011) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0429845) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 21074) | |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2025-07-24 |