| NPI | 1447299698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN MD37347) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 21843) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2025-06-27 |