| NPI | 1093860819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: IA 37824) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 16781) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2008-09-24 |