| NPI | 1174977904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD24325) |
| Additional Taxonomies | 2085N0904X (Licence: NH 22947) |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2024-03-29 |