| NPI | 1427496710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: CA A141049) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: KY 52128) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 52128) | |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2023-06-29 |