| NPI | 1932151628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 61747) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M4129) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D65508) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2026-06-10 |