| NPI | 1194278135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 40866) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PR 019744) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2025-04-30 |