| NPI | 1487684239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME97498) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: MI 4301052661) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301052661) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2024-02-16 |