| NPI | 1720259476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-14616) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA10797600) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 25072) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 63486) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD21932) | |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2025-09-04 |