| NPI | 1427310416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2018-00413) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN MD0000054526) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2024-09-30 |