| NPI | 1134100589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2019-0897) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 18053) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 327904) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2022-01-06 |