| NPI | 1063468734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0037574) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME160563) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX J7854) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2025-09-12 |