| NPI | 1639285521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD051388L) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: PA MD051388L) |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: PA MD051388L) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2010-07-22 |