| NPI | 1841330719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD442902) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD P17143) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2018-11-19 |