| NPI | 1487929758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101263813) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MD D0083138) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MD D83138) | |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2020-01-27 |