| NPI | 1033199344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0047894) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME73861) |
| 2085N0700X (Licence: MD D0047894) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2026-07-23 |