| NPI | 1942280250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0061101) |
| Additional Taxonomies | 2085N0700X (Licence: CO DR42791) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C10007472) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35084338) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD425084) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 101235797) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2008-03-27 |