| NPI | 1275536948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: OR MD23154) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: OR md23154) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2014-06-02 |