| NPI | 1932217916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 159175) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD28870) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2025-08-20 |