| NPI | 1427094465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AL MD8284) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM 2003-0375) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN MD37322) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 00008284) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2018-05-24 |