| NPI | 1659332427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 69216) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: NC 2005-01976) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2005-01976) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2023-10-26 |