| NPI | 1669784310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME118658) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CO 49003) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR0049003) | |
| Enumeration Date | 2010-07-10 |
| Last Update Date | 2016-11-28 |