| NPI | 1508816471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-10939) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 1329) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2013-11-26 |