| NPI | 1851467781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME107009) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 22767) |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2025-11-25 |