| NPI | 1992994487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 1041870) |
| Additional Taxonomies | 2085N0700X (Licence: FL ME 100215) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD-23867) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 264006) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 54494) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09087300) | |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2026-05-06 |