| NPI | 1275162927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2026-00931) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A177746) |
| Enumeration Date | 2020-04-05 |
| Last Update Date | 2026-03-21 |