| NPI | 1043299217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: OR MD28184) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: OR MD28184) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2019-04-11 |