| NPI | 1861467003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: VA 0101057220) |
| Additional Taxonomies | 2085R0001X (Licence: TX H8983) |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: MA 78485) | |
| 2085R0001X (Licence: VA 0101057220) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: TX H8983) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: FL ME69679) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2026-07-10 |