| NPI | 1841322179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 22693) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 41084) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2023-03510) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35090137) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2024-05-07 |