| NPI | 1861726952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME123698) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL MD.306043) |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2023-08-17 |