| NPI | 1316065758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD.009980) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C30462) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2007-12-03 |