| NPI | 1144894353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: MD H0106961) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 5101028174) |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2026-08-26 |