| NPI | 1053456806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A102748) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01063009A) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2008-06-28 |