| NPI | 1225011281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME83499) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 216768) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD23939) | |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2024-10-17 |