| NPI | 1215151162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD439656) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0009689) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08920000) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME167721) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2024-04-25 |