| NPI | 1427379726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 73726) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: AL MD.31153) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME141038) | |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2022-06-15 |