| NPI | 1144601352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2021-00354) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX BP10055766) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2023-08-15 |