| NPI | 1649923293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2024-01258) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ R79173) |
| Enumeration Date | 2022-02-02 |
| Last Update Date | 2024-10-15 |