| NPI | 1255027223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NE 2944) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 9891) |
| Enumeration Date | 2023-04-13 |
| Last Update Date | 2024-08-13 |