| NPI | 1740398643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO CDRH.0068990) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101288865) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 14675C) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01040751A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 34862) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2026-04-28 |