| NPI | 1518130442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 251620) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 71794) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-17480) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08725400) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD-24090) | |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2025-09-12 |