| NPI | 1871571836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME25503) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL 25503) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2017-11-21 |