| NPI | 1558364257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME 65690) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 36468) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-3842) | |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2016-12-08 |