| NPI | 1700895562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 21687) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G171015) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.134166) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2021-0857) | |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2024-03-21 |