| NPI | 1093835639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: WA MD00021552) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: WA MD00021552) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2009-09-27 |