| NPI | 1184760431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: PA MD437665) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: MD T4948) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2015-08-20 |