| NPI | 1982696530 |
|---|---|
| Professional Name | JACK L BAKER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX J2489) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX j2489) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2019-08-26 |