| NPI | 1225035751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-24566) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: IA MD-24566) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME45972) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: FL ME45972) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2018-10-12 |