| NPI | 1144218991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME72868) |
| Additional Taxonomies | 2085N0700X (Licence: VA 0101284099) |
| 2085N0700X (Licence: FL ME72868) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101284099) | |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2025-05-08 |