| NPI | 1831321819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD466212) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A116198) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 52517) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 249810) | |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2019-01-16 |