| NPI | 1881626695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 052753) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME95671) |
| 174400000X Specialist (Licence: GA 052753) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2016-05-10 |