| NPI | 1871574897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD08676) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 51698) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2024-03-15 |