| NPI | 1437320256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P7949) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A102830) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E8081) | |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2013-09-16 |