| NPI | 1144954017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: TX 173896) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: MD 173896) |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2024-02-13 |