| NPI | 1497965768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MT MED-PHYS-LIC-40592) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MT 40592) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2015-12-17 |