| NPI | 1114964038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 7497) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G26867) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME86091) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: MA 216622) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2011-06-21 |