| NPI | 1336842038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL DO.4208) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA 20A23093) |
| Enumeration Date | 2023-03-23 |
| Last Update Date | 2025-11-21 |