| NPI | 1245479054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0070240) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD456346) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME107187) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101250981) | |
| Enumeration Date | 2009-02-18 |
| Last Update Date | 2026-06-19 |