| NPI | 1265451702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 052861) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 23185) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2015-08-03 |