| NPI | 1215137385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 61461) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL29904) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2013-04-05 |