| NPI | 1447235783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0034289) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 13929) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VT 042-0011530) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0006079) | |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2021-07-14 |