| NPI | 1770516197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX J4275) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 43309) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 23304) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 7323A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 20357) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 9601364) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2022-01-26 |