| NPI | 1922078443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0102207925) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS010442L) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 05564) | |
| 208D00000X General Practice (Licence: PA OS010442L) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2026-09-29 |