| NPI | 1437495595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q7108) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2020-10-27 |