| NPI | 1326187675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD446849) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D72313) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0009193) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME150696) | |
| 208D00000X General Practice (Licence: VA 0101235036) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2023-01-11 |