| NPI | 1144458258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD468317) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 253071) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 157948) | |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2019-08-13 |