| NPI | 1043650443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: CA 161034) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: WI 63106) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2025-11-12 |