| NPI | 1750337499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME95368) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX L7382) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2011-02-24 |