| NPI | 1124214945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 26093) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M7639) |
| Enumeration Date | 2007-09-16 |
| Last Update Date | 2016-05-25 |