| NPI | 1306043831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME111984) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101284508) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 66267) | |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2025-08-18 |