| NPI | 1922115492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME119204) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 74246) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2025-08-18 |