| NPI | 1396249009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2019045772) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 43209) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2024-07-16 |