| NPI | 1427096767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 62957) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL 0053069) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL 0053069) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2018-11-28 |