| NPI | 1487726451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D16415) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101025772) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD5874) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2012-12-06 |