| NPI | 1720256381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL me144578) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 257240) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: LA md201838) | |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2022-10-17 |