| NPI | 1912978172 |
|---|---|
| Former Name | ROY LAURENCE MOSS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 211084) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: PA MD434403) |
| 2085N0904X Radiology Nuclear Radiology (Licence: PA MD434403) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME100670) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MD D0063405) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: PA MD434403) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2024-04-01 |