| NPI | 1780667964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: CO DR.0060904) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 010236806) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: VA 0101236806) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2024-02-16 |