| NPI | 1144204371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD30038) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0050747) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA O101054230) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00043994) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2013-06-17 |