| NPI | 1083934277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: ND PT20482) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: VA 0101257722) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2025-05-01 |