| NPI | 1598791535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MS 13170) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 13170) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2025-12-05 |