| NPI | 1225215486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 29612) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 001438) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2015-10-05 |