| NPI | 1902803562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME103541) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 34395) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 34395) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101245169) | |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2023-12-20 |