| NPI | 1255505368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD164147) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 141410) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2024-06-11 |