| NPI | 1669455028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 11820) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 043127) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2013-06-03 |