| NPI | 1326074188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME98300) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 044195) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2018-08-16 |