| NPI | 1982683140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME 009628) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR 30174) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2007-08-26 |