| NPI | 1225472392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D87397) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MD D87397) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 69972) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX U4683) | |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2023-12-28 |