| NPI | 1952938540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME182063) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A200318) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AL L.5130R) | |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2026-08-21 |