| NPI | 1851342257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2007011172) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D64273) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2011-12-07 |