| NPI | 1316506959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D91411) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC LL82423) |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2024-03-08 |