| NPI | 1922051374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME94562) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M4346) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2026-04-24 |