| NPI | 1750375390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MD D32578) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: VT 042-0010984) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NH 12673) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: WA MD00038186) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: LA MD201248) | |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2024-02-23 |