| NPI | 1932139409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX 42247) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 223797) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME 109356) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A99222) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2016-11-23 |