| NPI | 1467420133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X (Licence: MA 158583) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: MA 158583) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2017-12-20 |