| NPI | 1134330285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD151255) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 76568) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2026-07-20 |