| NPI | 1831422377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 227520) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME114127) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD18761) | |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2025-01-28 |