| NPI | 1518290451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 32850-020) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G46735) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.071183) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME 60328) | |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2009-09-10 |