| NPI | 1427265537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2008-00480) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 222245) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2016-06-24 |