| NPI | 1306817655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 9310) |
| Additional Taxonomies | 2085N0904X Radiology Nuclear Radiology (Licence: AZ 9310) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2008-05-30 |