| NPI | 1992064406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS15923) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 1070) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 1070) | |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2021-12-17 |