| NPI | 1841463452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 109335) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0057251) |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2026-04-20 |