| NPI | 1588871073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101246235) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 22111) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD038550) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D70816) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2019-06-19 |