| NPI | 1447412507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2020-01408) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D75533) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2020-06-08 |