| NPI | 1841258597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD430928) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 227222) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2016-06-03 |