| NPI | 1427276211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 14558) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301088541) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DC Md039608) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2017-10-20 |