| NPI | 1932291309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD20055) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00038143) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME0059661) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-079566) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2007-07-08 |