| NPI | 1225251077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD431455) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301077680) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C10008462) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08513400) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2012-09-11 |