| NPI | 1740287887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD033846L) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C56086) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2014-06-30 |