| NPI | 1902244122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS023242) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 33438) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI DOS-1661) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MB11328400) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ME DO3855) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2024-07-22 |