| NPI | 1700013356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME124060) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT194492) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2015-07-13 |