| NPI | 1851345862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME24368) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 11321) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35-04-6413-K) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 48525) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 26063) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD-031175-E) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 19304) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01042077A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301062874) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101050752) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0046723) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2009-08-25 |