| NPI | 1134218944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME100229) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN10012) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2011-08-01 |