| NPI | 1043211576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME78848) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 101258) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2025-10-14 |