| NPI | 1558584235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 5414497-1205) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: MT 12484) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MT 12484) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2026-04-27 |