| NPI | 1275531683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: MO 2001017188) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME76944) |
| Enumeration Date | 2005-07-09 |
| Last Update Date | 2021-08-26 |