| NPI | 1083602817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME87022) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 99185) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2025-10-01 |