| NPI | 1548224322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX L8632) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 21832) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2025-08-13 |