| NPI | 1487612784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME144253) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: LA 023438) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 023438) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2021-08-02 |