| NPI | 1093788770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 25453) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G8697) |
| Enumeration Date | 2006-02-11 |
| Last Update Date | 2019-06-12 |