| NPI | 1851517999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 13857) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301083659) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.093043) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 43663) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2024-04-24 |