| NPI | 1235524844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: NC 2021-00464) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD469815) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2021-00464) | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2022-03-29 |