| NPI | 1184646499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME93060) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101102559) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 81188) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2025-08-16 |