| NPI | 1184185191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL 158951) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 1022227) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 34051) | |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2025-04-20 |