| NPI | 1952324121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 14029) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A79577) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2014-06-17 |