| NPI | 1467443101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D69147) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC MD 11500) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2009-10-14 |