| NPI | 1447781182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 91854) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 34010) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME159458) | |
| 208600000X Surgery (Licence: SC LL40844) | |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2023-01-12 |