| NPI | 1851617146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D89019) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: PA MD448576) |
| 208600000X Surgery (Licence: PA MD448576) | |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2021-05-26 |