| NPI | 1295726750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME151509) |
| Additional Taxonomies | 2085N0700X (Licence: FL ME151509) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0043048) | |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2024-11-13 |