| NPI | 1306307525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 99057) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: GA 99057) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2024-03-11 |