| NPI | 1154818136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: AL MD.38905) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL52818) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2023-01-26 |