| NPI | 1578659926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 96-00568) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2013-0193) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2014-04-21 |