| NPI | 1164658472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0072431) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA md458383) |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2019-04-24 |