| NPI | 1467423707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2010-00996) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 00022457) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 252088-1) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2010-07-20 |