| NPI | 1861491367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 35929) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 17389) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 34700) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME112931) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 67934) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 46028) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.122065) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 8184938-1205) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2023-08-09 |