| NPI | 1225327406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: TX R2308) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R2308) |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2025-05-30 |