| NPI | 1356391908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME 106216) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 1338) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2014-04-09 |