| NPI | 1316566565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 1016602) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL 178836) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.155056) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 342803) | |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2026-07-17 |