| NPI | 1043311517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MD D92487) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: TX L3722) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2022-01-24 |