| NPI | 1528221983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: CA A124719) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME154637) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2022-02-17 |