| NPI | 1508072711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 16199) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL RTN9896) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NV SP377) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2015-12-07 |