| NPI | 1508908088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA md429208) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ ma08121800) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME168300) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0009583) | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2024-05-16 |