| NPI | 1558339846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME67572) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL 67572) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2020-03-25 |