| NPI | 1801992888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036145552) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 25591) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35065687) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301062271) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 29773) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: IA MD-29773) | |
| 2085B0100X Radiology, Body Imaging (Licence: IA MD-29773) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 46401) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2024-07-02 |