| NPI | 1336583277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD15117) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 273582) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2018-12-05 |