| NPI | 1073584835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD055896L) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MD D0041184) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2016-06-29 |