| NPI | 1144365107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M8493) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 23503) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2012-06-27 |