| NPI | 1316261118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 249368) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A110957) |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2011-09-07 |