| NPI | 1942370580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME107580) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 058284) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2016-03-07 |