| NPI | 1417993262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 11277) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VT 042.0010258) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2017-12-26 |