| NPI | 1578548822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 11374) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 00026608) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD421948) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA07864300) | |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2024-02-23 |