| NPI | 1326108333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0032756) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 46005) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 7774A) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2025-08-18 |