| NPI | 1437726213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: UT 14279462-1205) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-53081) |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2026-07-22 |