| NPI | 1457523987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME104023) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD433914) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D80591) | |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2016-09-16 |