| NPI | 1275664096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0065892) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PR 18576) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2023-04-28 |