| NPI | 1144276346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 9501488) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 36871) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2013-02-27 |