| NPI | 1144752817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0086839) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 103534) |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2026-06-23 |