| NPI | 1407818263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME99307) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME99307) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: FL ME99307) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2014-06-26 |