| NPI | 1013242098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 250734) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA a 107408) |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2014-06-28 |