| NPI | 1144489667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2015-01706) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2008-0207) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2018-12-05 |