| NPI | 1013565894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MT MED-PHYS-LIC-169779) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 1025902) |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2026-04-19 |