| NPI | 1881690162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME59806) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME 015800) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 30134) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G86380) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2025-08-26 |