| NPI | 1144372020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 05437) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 1314) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2011-12-22 |