| NPI | 1346700382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 20A22468) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: KS 94-10225) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2024-06-25 |