| NPI | 1275682981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101055408) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MD D0043342) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: DC MD19943) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2011-10-26 |