| NPI | 1477045284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD479088) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL TPME5446) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX T8248) | |
| 208600000X Surgery (Licence: PA MT215706) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GU MTL-2026-010) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GU M-2527) | |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2026-07-28 |