| NPI | 1265270300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 80.000098) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL L.6407F) |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2026-08-28 |