| NPI | 1225655749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME173325) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 38205) |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2025-04-17 |