| NPI | 1447426275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA OS017558) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MI 5101016619) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2015-08-28 |