| NPI | 1558565226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 52247-20) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 52247) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2013-06-13 |