| NPI | 1609950534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0010485) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: MD D0050440) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0050440) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2018-09-10 |