| NPI | 1952371023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: MT MED-PHYS-LIC-88021) |
| Additional Taxonomies | 2085N0700X (Licence: WI 60753 - 20) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MT MED-PHYS-LIC-88021) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 60753) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2025-04-18 |