| NPI | 1891374427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD29924) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 38859) |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2026-05-14 |