| NPI | 1144593005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 49877) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME103684) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 266708-1) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA10329200) | |
| Enumeration Date | 2012-02-22 |
| Last Update Date | 2024-05-03 |