| NPI | 1952395691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25IA12577400) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD423298) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2026-00537) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME182323) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 28934) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA IMLC.MD.70104343) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 76762) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX W5172) | |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2026-08-03 |