| NPI | 1649850082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PA Md487062) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME158463) |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2024-10-01 |