| NPI | 1538494877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0070304) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 225964) |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2013-08-01 |