| NPI | 1922091115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 18135) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 000018135) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2010-07-20 |