| NPI | 1821242942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD206655) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MT 28432) |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2022-07-21 |