| NPI | 1881640688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 41232) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: CO 41232) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2008-04-17 |