| NPI | 1487634861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR 26811) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 10956) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A65386) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00041078) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2007-11-08 |