| NPI | 1407291743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD20032) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 274155) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2024-08-23 |