| NPI | 1487074332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 61676) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 299736-01) |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2025-11-26 |