| NPI | 1508943184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 14907) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 26978) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2012-04-10 |