| NPI | 1841511672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301096717) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MI 4301096717) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 76827) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 275690) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD495092) | |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2026-06-02 |