| NPI | 1932172228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A70337) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI 10431) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2010-05-21 |