| NPI | 1295926483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME151356) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD29467) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 35244) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N3336) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2025-12-03 |