| NPI | 1326081993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX H5862) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: TX H5862) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-04-15 |