| NPI | 1821087750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 60245) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: RI MD08843) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MI 4301042192) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01076888A) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD444247) | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2019-10-08 |