| NPI | 1952516825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: VA 0101263096) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2007012296) |
| 2085N0700X (Licence: MO 2007012296) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101263096) | |
| Enumeration Date | 2007-05-13 |
| Last Update Date | 2026-01-23 |