NPI | 1003357294 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME165011) |
Additional Taxonomies | 2085N0700X (Licence: FL ME165011) |
Enumeration Date | 2017-03-20 |
Last Update Date | 2025-07-11 |