| NPI | 1508217050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 71487) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 23189) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35C.004037) | |
| 207R00000X Internal Medicine (Licence: IA R10617) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 14497-320) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-49411) | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2026-05-04 |