| NPI | 1346131034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0205X Radiology, Radiological Physics (Licence: TX FMP02000390) |
| Additional Taxonomies | 2085R0205X Radiology, Radiological Physics (Licence: MA 65-0880) |
| Enumeration Date | 2025-07-11 |
| Last Update Date | 2025-07-11 |