| NPI | 1346448925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 10630) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 50073) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2014-09-19 |