| NPI | 1861576530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD419155) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0010427) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0073496) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2018-08-13 |