| NPI | 1053587485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD451490) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: PA MD451490) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2007-00471) | |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2018-11-06 |