| NPI | 1447605704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0096589) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 68697) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME166355) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD474970) | |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2025-10-14 |