| NPI | 1417097684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0072002) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101249287) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD039193) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2022-02-08 |