| NPI | 1437771490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2025-00613) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ID 6181303) |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2026-06-08 |