| NPI | 1346288669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME131980) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 73844) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2025-01-09 |