| NPI | 1013907609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 13326) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 59774) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2007-12-18 |