| NPI | 1093729105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101241858) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 200401272) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 27247) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME88631) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2014-02-20 |