| NPI | 1750584348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2008-02085) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL MD28086) |
| Enumeration Date | 2007-06-09 |
| Last Update Date | 2009-03-27 |