| NPI | 1932151628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D65508) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M4129) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2008-07-01 |