| NPI | 1538571856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D89474) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA L-259657) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2022-11-02 |