| NPI | 1366465080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD.022201) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 22201) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2009-09-03 |