| NPI | 1285609339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD036894) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD420819) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 42644) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD420819) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2023-08-23 |