| NPI | 1588870604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD438541) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT186288) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2016-11-09 |