| NPI | 1316300320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL OS20088) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MO 2021012454) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: OK 7592) | |
| 208D00000X General Practice (Licence: OK 7592) | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2024-02-13 |