| NPI | 1184773186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: GA 104252) |
| Additional Taxonomies | 2085N0700X (Licence: NY 334141) |
| 2085N0700X (Licence: MD D72496) | |
| 2085N0700X (Licence: DE C1-0026468) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0026468) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D72496) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 104252) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2025-08-07 |