| NPI | 1326305483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101263229) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A158804) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA10439500) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 57073) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD466340) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-14417) | |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2025-09-10 |