| NPI | 1851456040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101026655) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD33080) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0019984) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2011-11-14 |