| NPI | 1164682803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: FL ME113828) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: FL ME113828) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2026-06-15 |