| NPI | 1083141097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-48973) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: IA MD-48973) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-17227) | |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2023-05-31 |