| NPI | 1750503496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD042591) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2026-02673) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 243269-1) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD23893) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX V0550) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2026-06-03 |