| NPI | 1851568489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: NC 2013-01736) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 158560) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2025-10-03 |