| NPI | 1487117826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD600006162) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: FL ME175877) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2026-07-06 |