| NPI | 1306987995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME110653) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D67444) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2016-09-14 |