| NPI | 1073526240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD421094) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 254865) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2026-06-02 |