| NPI | 1033308531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 14231) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A103292) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2012-06-25 |