| NPI | 1821439365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-49312) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 136562) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2022-08-01 |