| NPI | 1467912352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 103252) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PR 24467) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME151140) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2025-11-18 |