| NPI | 1538150180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P6758) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 213372) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2014-01-29 |