| NPI | 1336119155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 47003) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-113439) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N0516) | |
| 2085N0700X (Licence: TX N0516) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 340918) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2026-03-25 |