| NPI | 1184043184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 52597) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY R3674) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2023-09-20 |