| NPI | 1477909356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX T5684) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: NC 2021-00635) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2021-00635) | |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2025-12-02 |