| NPI | 1316956154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X (Licence: MD D0029285) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0029285) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2025-09-11 |