| NPI | 1407009566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QR0208X Clinic/Center, Radiology, Mobile |
| Additional Taxonomies | 261QR0206X Clinic/Center, Radiology, Mammography (Licence: FL 61478) |
| Enumeration Date | 2008-11-02 |
| Last Update Date | 2008-11-02 |