| NPI | 1437120854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME 26904) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 19471) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 3120) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI 11237) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MT 9794) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00039327) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2010-10-20 |