| NPI | 1568564300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0068124) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD426786) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NY 217201) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MA07427300) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2022-10-06 |