| NPI | 1497988166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0074477) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301090368) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 15299) | |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2013-02-28 |