| NPI | 1922637784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME173686) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-56187) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2026-03-25 |