| NPI | 1417063355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME 017401) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 226212) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2010-08-04 |