| NPI | 1902072143 |
|---|---|
| Former Name | LOUIE ANTHONY ENRIQUEZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 47463) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 57.007488) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35091905) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 25359) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-36449) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD17509) | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2022-12-09 |