| NPI | 1326037169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD465207) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 200001151) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2022-07-05 |