| NPI | 1932255619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO CDRH.0048944) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 48944) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2025-04-02 |