| NPI | 1861456444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 277461) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX L8886) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2015-06-29 |