| NPI | 1336154608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: FL ME0065325) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME0065325) |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: FL ME0065325) | |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2007-07-11 |