| NPI | 1740408384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 24353) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 29330) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR 228062) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0071266) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX W1553) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2026-06-09 |