| NPI | 1346428513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 5755330-1205) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0053534) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A117357) | |
| Enumeration Date | 2008-02-09 |
| Last Update Date | 2018-04-10 |