| NPI | 1023212214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME106630) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 23800) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2026-02-02 |