| NPI | 1376119503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: FL ME171163) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME171163) |
| Enumeration Date | 2021-05-28 |
| Last Update Date | 2025-02-07 |