| NPI | 1821187287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MO 35672) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AR R-3158) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA C38691) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-27841) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: OK 20965) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD024689E) | |
| 2085R0202X Radiology Diagnostic Radiology | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2007-07-08 |