| NPI | 1114988813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME0023206) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: FL ME0023206) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: FL ME0023206) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2007-07-10 |