| NPI | 1841785854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME141779) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 91577) |
| 208600000X Surgery (Licence: TX BP10063106) | |
| 208600000X Surgery (Licence: TX 10063106) | |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2024-06-14 |