| NPI | 1730918590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA SP-0291) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: IA SP-0291) |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: IA SP-0291) | |
| Enumeration Date | 2024-07-30 |
| Last Update Date | 2024-07-30 |