| NPI | 1841269750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD25751) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 47854) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2024-12-20 |