| NPI | 1164630117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA11606800) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: IA MD49096) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 25771) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101239243) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD207467) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-14089) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-34422) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 41344) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2025-08-20 |