| NPI | 1528801388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: MO 2025021025) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2024021804) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2025021025) | |
| Enumeration Date | 2024-06-18 |
| Last Update Date | 2025-08-13 |