| NPI | 1477572865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME127529) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD424099) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09857900) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301111424) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2023-07-12 |