| NPI | 1265431324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: MD D31378) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: DC 14602) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D31378) | |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2019-09-10 |