| NPI | 1548223860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD423993) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M9117) |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2024-08-23 |