| NPI | 1336227354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OR MD09467) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD09467) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2010-04-14 |