| NPI | 1134195134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 36224) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 051244) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2018-02-22 |