| NPI | 1295359909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD600004623) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD H0104039) |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2025-09-09 |