| NPI | 1558545574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE c10009072) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 237798) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D67597) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD460717) | |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2024-02-26 |