| NPI | 1346353737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 41768) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A82457) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2017-08-11 |