| NPI | 1447566971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2022-0276) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY FL046) |
| Enumeration Date | 2010-08-21 |
| Last Update Date | 2023-07-14 |