| NPI | 1548396906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 052547) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101290103) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY C6153) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 46102) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2026-10-01 |