| NPI | 1467471235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME81325) |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology (Licence: FL ME81325) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2024-02-02 |