| NPI | 1194229906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A164515) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 227235) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2025-03-12 |