| NPI | 1114248283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: NM MD2015-0799) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2015-0799) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2025-05-28 |