| NPI | 1851300446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME0012220) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: FL ME12220) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME12220) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2015-01-21 |