| NPI | 1487092482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: MD 1020905) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: VA 0120011311) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2022-12-31 |