| NPI | 1225052046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MT 12676) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MT 12676) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2017-06-29 |