| NPI | 1487151536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME163076) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL MD.46805) |
| 208D00000X General Practice (Licence: LA 327710) | |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2024-02-07 |