| NPI | 1245339530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 6326994-1205) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 018286) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2007-07-08 |