| NPI | 1952303208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL MD.23957) |
| Additional Taxonomies | 174400000X Specialist (Licence: AL 00023957) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2019-02-07 |