| NPI | 1881198273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 102499) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 300877) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A163810) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 26907) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2025-10-01 |