| NPI | 1891825352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D67338) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 7816) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2023-01-19 |