| NPI | 1326156282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: ID M10624) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: WA ML20007607) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2010-04-20 |