| NPI | 1427214543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 44349) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 44349) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2017-03-06 |