| NPI | 1902876832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MD D0060641) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: MD D0060641) |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: MD D0060641) | |
| 208D00000X General Practice (Licence: MD D0060641) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2024-04-01 |