| NPI | 1366408809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 13603) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 9300387) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 053458) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX H3562) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2015-06-11 |