| NPI | 1033313465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME139396) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2010007603) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AL L.3416SP) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-09-02 |