| NPI | 1528160777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: PA MD444582) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 246327) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A98462) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01063473A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD444582) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M9778) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2006001569) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2025-07-02 |