| NPI | 1447240171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 056888) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC MMD5688MD) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2025-08-05 |