| NPI | 1902196249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD178927) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR 178927) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2018-06-18 |