| NPI | 1144758467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 26368) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 26372) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A186678) | |
| 208600000X Surgery (Licence: SC LL41011) | |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2025-01-14 |