| NPI | 1487626164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME91535) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 00006494) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 37075) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2014-11-07 |