| NPI | 1033503990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ID 5181501) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR DO228994) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 1544) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 203231) | |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2026-03-31 |