| NPI | 1073808101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2018-00043) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD190554) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2023-01-19 |