| NPI | 1831628049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 54656) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME151908) |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2026-10-11 |