| NPI | 1417187246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-43585) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 58329) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2018-01-10 |