| NPI | 1134128051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology Nuclear Radiology (Licence: MD D16341) |
| Additional Taxonomies | 2085N0904X Radiology Nuclear Radiology (Licence: DC MD25540) |
| 2085N0904X Radiology Nuclear Radiology (Licence: VA 019671) | |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2008-03-14 |