| NPI | 1245455252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-6352) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N1589) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2011-01-07 |