| NPI | 1073544466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME27525) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 18687) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101031837) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-056460) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 12551) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2007-07-08 |