| NPI | 1023000338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 17846) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 11403C) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GU MTL-2023-029) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 15260) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2018024521) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GU M-2421) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2024-01-31 |