| NPI | 1134356322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 56303) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 42460) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.137540) | |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2015-07-15 |