| NPI | 1558397976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2026010954) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 29548) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01062817A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M8540) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 40770) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 060799) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC MD33482) | |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2026-07-02 |