| NPI | 1306847165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD051144L) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA md051144l) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2024-12-06 |