| NPI | 1548277494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 14635) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI 10002) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2011-11-01 |