| NPI | 1326041500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: PR 10382) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PR 10382) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2024-09-12 |