| NPI | 1134390743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME119783) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 269478) |
| Enumeration Date | 2008-03-23 |
| Last Update Date | 2016-10-06 |