| NPI | 1730525742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD221925) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2018-0143) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.144431) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 14215783-1205) | |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2025-07-28 |