| NPI | 1942486873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: FL ME117274) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: MD D0068429) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD439508) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME117274) | |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2015-03-09 |