| NPI | 1326493065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: MI 5101026270) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: PA OS021242) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2022-09-11 |