| NPI | 1962458000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME58711) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M8358) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2016-03-07 |