| NPI | 1134227804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: FL ME114297) |
| Additional Taxonomies | 2085N0700X (Licence: MO 2021031383) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 36116107) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2021031383) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL me114297) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2025-02-27 |