| NPI | 1922190214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 7426) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME DO2738) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-05-19 |