| NPI | 1407983216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: LA MD.203996) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M5863) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M5863) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2011-01-04 |