| NPI | 1396726139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD09966) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 72894) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2019-03-21 |