| NPI | 1083608053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 014966) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 14966) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2015-07-27 |