| NPI | 1407888472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TN 7739) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MS 18455) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2011-02-24 |