| NPI | 1730112756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 52357) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE 0003247) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2015-02-25 |