| NPI | 1467597427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: GA 64150) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: MN 19205) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2015-10-15 |