| NPI | 1336166842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD007566E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD007566E) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2009-04-01 |