| NPI | 1750371852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS013840) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI DOS-2454) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA12159200) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-16821) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 010261) | |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2025-09-04 |