| NPI | 1255534160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD436277) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: PA MT185539) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2009-04-20 |