| NPI | 1184663890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME 93179) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NC 200201061) |
| 174400000X Specialist (Licence: NC 200201061) | |
| 207R00000X Internal Medicine (Licence: FL ME 93179) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2023-03-07 |