| NPI | 1922256650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD436037) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 341444) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME142124) | |
| Enumeration Date | 2008-09-06 |
| Last Update Date | 2026-08-07 |