| NPI | 1447008164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC MMD94442LL) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC RTL24-0115) |
| Enumeration Date | 2024-05-08 |
| Last Update Date | 2025-07-11 |