| NPI | 1063502862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS17099) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: MS 20391) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 20391) | |
| 208D00000X General Practice (Licence: MS 20391) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2024-04-08 |