| NPI | 1699271288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-13638) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR T2020-431) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2024-10-29 |