| NPI | 1477617702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101042918) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D23472) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2007-07-08 |