| NPI | 1427254457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q5672) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D68527) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2005020162) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2015-10-19 |