| NPI | 1952372971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: OK 28293) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: HI 9901) |
| 2085B0100X Radiology, Body Imaging (Licence: CA G82305) | |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2020-10-14 |