| NPI | 1336374305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME109220) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: CT 047375) |
| 2085B0100X Radiology, Body Imaging (Licence: FL ME109220) | |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2015-07-16 |