| NPI | 1407933351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D68973) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101245632) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD037995) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A66052) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2021-06-01 |