| NPI | 1538194774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 52338) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 246919) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2013-12-11 |