| NPI | 1235183435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME0031722) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: FL ME0031722) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 131808-1) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA 419229) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 21975) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2016-05-27 |