| NPI | 1508361288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 100897) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0097175) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD471626) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 321374) | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2024-09-06 |