| NPI | 1427935188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085B0100X Radiology Body Imaging (Licence: CA 31029) |
| Additional Taxonomies | 2085U0001X Radiology Diagnostic Ultrasound (Licence: CA 31029) |
| Enumeration Date | 2025-08-16 |
| Last Update Date | 2025-08-16 |