| NPI | 1235156894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME68218) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 49720) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2025-09-06 |