| NPI | 1447458971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME103658) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 244984) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D67244) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2009-11-18 |