| NPI | 1952340200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 8030A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 32638) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2008-11-03 |