| NPI | 1326029166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MA 50755) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI 13160) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 14769) | |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2025-10-28 |