| NPI | 1417111477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD459298) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 330985) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 68451) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101266486) | |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2026-05-07 |