| NPI | 1639137342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: WA MD00043606) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2017-02-15 |