| NPI | 1003014473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD439457) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: DE C1-0013159) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0013159) | |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2019-07-03 |