| NPI | 1043509151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 265682) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 252360) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2025-12-15 |