| NPI | 1821202623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101251973) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE CL-0003744) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2013-07-12 |