| NPI | 1710104484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 43773) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M6052) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 29216) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME107556) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 63634) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 20968) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2010-00231) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 32233.MD) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN MD0000045451) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2015-08-07 |