| NPI | 1598375073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 343507) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01092570A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125079173) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301518177) | |
| Enumeration Date | 2020-08-09 |
| Last Update Date | 2026-08-21 |