| NPI | 1023024189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: FL 29054) |
| Additional Taxonomies | 2085R0001X (Licence: GA 029347) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2015-04-21 |