| NPI | 1922025618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101225839) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD039182) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0060078) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2022-02-07 |