| NPI | 1356578702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D88149) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL 14701) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD047729) | |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2019-12-17 |