| NPI | 1265478309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: CA G30525) |
| Additional Taxonomies | 2085N0904X (Licence: CA G30525) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2014-04-28 |