| NPI | 1437360864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301086293) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH AU2866626-U038) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2011-05-11 |