| NPI | 1841550886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 81197) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA pending) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2024-02-19 |