| NPI | 1568408474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X (Licence: MD D0027629) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D00276929) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2014-01-02 |