| NPI | 1033422951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology Body Imaging (Licence: CA 20A13403) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: OK 4943) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2014-07-11 |