| NPI | 1720210206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME 48417) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: FL ME 48417) |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2024-11-10 |