| NPI | 1689884330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD450441) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N9622) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2024-10-08 |