| NPI | 1952618324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME123237) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PR 12740-qI) |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2016-01-13 |