| NPI | 1316181092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D69487) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 236247) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL TPME5505) | |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2024-09-05 |