| NPI | 1225073729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: FL me95564) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL me95564) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2007-09-18 |