| NPI | 1447315676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME115966) |
| Additional Taxonomies | 2085R0001X (Licence: FL ME115966) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2025-10-06 |