| NPI | 1518932425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD018683E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD018683E) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2010-03-26 |