| NPI | 1821010752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD28311) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 6160668-1205) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 23765) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101241650) | |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2017-02-27 |