| NPI | 1336341726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MT 57972) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A106816) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME103555) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2020-09-22 |