| NPI | 1437832508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: PA MT230342) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: DE C7-0018187) |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2024-09-01 |