| NPI | 1083832521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME93955) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL me93955) |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2021-08-03 |