| NPI | 1417905522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD158097) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: AZ 19560) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME139580) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036131854) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101288870) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0025605) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2026-05-08 |