| NPI | 1942450341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD439851) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 105363) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2016-10-13 |