| NPI | 1891772604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 18979) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.080554) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD DO041346) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 33032) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2024-04-18 |