| NPI | 1447221593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101243052) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A91817) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2008-10-29 |