| NPI | 1073595740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME94727) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX bp10024058) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2024-01-12 |