| NPI | 1043536576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SD 18014) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 51925) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME129702) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01071833A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2025-00400) | |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2026-04-22 |