| NPI | 1144993262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: PA MD485224) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: PA MD485224) |
| Enumeration Date | 2021-07-26 |
| Last Update Date | 2024-05-06 |