| NPI | 1033250071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D62031) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD z5550) |
| Enumeration Date | 2007-02-11 |
| Last Update Date | 2014-04-09 |