| NPI | 1538344577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD042060) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101247195) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SD 8356) | |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2015-03-14 |