| NPI | 1083703235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME96730) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL TRN6568) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2008-04-04 |