| NPI | 1487856563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME 97615) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: FL ME 97615) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2009-09-14 |