| NPI | 1730316118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101248850) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD461114) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.131162) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 50464) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME138790) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MDR-5717) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301111995) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 288776) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01079280A) | |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2025-01-08 |