| NPI | 1891938916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME120255) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.054799) |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2014-06-27 |