| NPI | 1164050175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 102479) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 326595) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2024-12-08 |