| NPI | 1437311321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X (Licence: TX P9400) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 102292) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2025-01-14 |