NPI | 1730525742 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD221925) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2018-0143) |
2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.144431) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: UT 14215783-1205) | |
Enumeration Date | 2013-05-16 |
Last Update Date | 2025-07-28 |