| NPI | 1477507762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD419061) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: PA MD419061) |
| 2085N0700X (Licence: PA MD419061) | |
| 2085N0904X (Licence: PA md419061) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: PA MD419061) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2016-07-21 |