| NPI | 1508950528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD430226) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 46986) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-10-07 |