| NPI | 1043247547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-5653) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 12521) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2008-10-13 |