| NPI | 1871555649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00045333) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 9680A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A92436) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GU MC-165) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 15107) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2005020838) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M9395) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2025-05-01 |