| NPI | 1952984296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2025-1056) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD29984) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 38977) | |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2026-07-08 |