| NPI | 1427249614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N8223) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX BP2-0029112) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 31948) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2017-05-23 |