| NPI | 1316489321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0205X Radiology, Radiological Physics (Licence: FL TRP561) |
| Additional Taxonomies | 171W00000X Contractor (Licence: TX MP10336) |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2023-12-14 |