| NPI | 1942276506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME77450) |
| Additional Taxonomies | 2085R0203X Radiology Therapeutic Radiology (Licence: FL ME77450) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2007-07-08 |