| NPI | 1205368545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 290876) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD206542) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME159594) | |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2023-08-11 |