| NPI | 1669057238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 113477) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD600005917) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD DO107119) | |
| Enumeration Date | 2021-03-15 |
| Last Update Date | 2026-08-17 |