| NPI | 1487274312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD495188) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 1021956) |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2026-07-30 |