| NPI | 1134377518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: FL ME 124558) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN11669) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2016-08-06 |