| NPI | 1821052820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD073987L) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C10003902) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2018-11-19 |