| NPI | 1699747170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0057205) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 4947) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2020-12-15 |