| NPI | 1841209236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 10166) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME90262) |
| 208D00000X General Practice (Licence: KS 04-14664) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2016-01-27 |