| NPI | 1447256425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 27708) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 24080) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2015-09-22 |