| NPI | 1992756050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 23995) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 44345) |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2008-11-25 |