| NPI | 1275186280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME157988) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: MN 30953) |
| 2085N0700X Radiology, Neuroradiology (Licence: MN 29786) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: MN 31785) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 32731) | |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2023-08-21 |