| NPI | 1699746354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D61849) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2017-06-13 |