| NPI | 1053507434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: VT 042.0012785) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: UT 6353586-1205) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2014-01-31 |