| NPI | 1922024983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0106356) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2010007772) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 1027606) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2026-05-18 |