| NPI | 1588763635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-36277) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 35.137191) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2022-01-11 |