| NPI | 1346209624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD428459) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D63043) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME155125) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2023-03-31 |