| NPI | 1457884041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 308041) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D94019) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX V2228) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2023-02158) | |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2024-11-19 |