| NPI | 1396705257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M4481) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E3617) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2018-02-21 |