| NPI | 1083684765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: GA 051798) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: GA 51798) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2016-03-03 |