| NPI | 1750341483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G67457) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 34673) |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2014-08-21 |