| NPI | 1417951914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD15429) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME 015429) |
| 208600000X Surgery (Licence: ME 015429) | |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2023-07-05 |