| NPI | 1992754147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MO 108795) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: KS 27993) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NY 217890) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 3712) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NC 2003-00113) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IA 3760) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IL 36116632) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2009-04-14 |