| NPI | 1023244621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX V9347) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0079427) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A113984) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 305291) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD479075) | |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2025-08-20 |