| NPI | 1083970909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME138738) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 74916) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AL MD.36686) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2025-10-02 |