| NPI | 1518113398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0070425) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101247045) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD038533) | |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2022-01-18 |