| NPI | 1447402425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: ID O-0744) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: ID O-0744) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2014-07-10 |