| NPI | 1467451435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 27980) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 28672) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2007-07-08 |