| NPI | 1922084953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 46534-20) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 46534) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2012-08-27 |