| NPI | 1518966118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD042743E) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35087821) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 271141) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 36172) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2025-01-21 |