| NPI | 1427028802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 024743) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 15956) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2012-10-24 |