| NPI | 1376531228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: WI 48972) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: IA 3624) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2022-11-17 |