| NPI | 1831116649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085B0100X Radiology Body Imaging (Licence: FL ME134315) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: VT 042-0009657) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2019-05-09 |