| NPI | 1689724346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME31804) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM 2004-0722) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2025-06-13 |