| NPI | 1518359884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS17943) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: FL OS17943) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL UO4401) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0064406) | |
| 208D00000X General Practice (Licence: FL UO4401) | |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2023-05-01 |