| NPI | 1295948206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 3885) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 8421) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2009-06-01 |