| NPI | 1942732342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 103836) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0102209386) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 1991) | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2025-10-02 |