| NPI | 1275553349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: GA 027617) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: FL ME 94570) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2007-07-08 |