| NPI | 1760684997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME110872) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: FL ME 110872) |
| 207R00000X Internal Medicine (Licence: FL ME 110872) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2013-12-13 |