| NPI | 1467448480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: FL ME61567) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: FL ME61567) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2010-01-27 |