| NPI | 1457475105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D38270) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD16991) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101043781) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0038270) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2023-05-07 |