| NPI | 1942542295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: IA md-47793) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA md-47793) |
| 208600000X Surgery (Licence: WA ML60370384) | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2021-07-12 |