| NPI | 1407956238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD426701) |
| Additional Taxonomies | 2085N0904X Radiology Nuclear Radiology (Licence: PA MD426701) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2008-02-09 |