| NPI | 1497803654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 17271) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 27410) |
| Enumeration Date | 2007-01-06 |
| Last Update Date | 2008-02-21 |