| NPI | 1275569212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD460733) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MD D0036366) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2017-08-24 |