| NPI | 1740488527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 23953) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 69668) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME178748) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301100035) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2026-04-03 |