| NPI | 1154346823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 50855-021) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 010364) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2007-09-20 |