| NPI | 1427319813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 269541) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q8638) |
| Enumeration Date | 2012-06-03 |
| Last Update Date | 2017-02-23 |