| NPI | 1033194253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101242706) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A81322) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35079892) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: CA A81322) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: OH 35079892) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0025771) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD26502) | |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2026-05-14 |