| NPI | 1245374537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 052198) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M5813) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2016-08-18 |