| NPI | 1881866101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME100678) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME 100678) |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2022-11-02 |