| NPI | 1578566964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: GA 027048) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: FL 0042409) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2011-10-13 |