| NPI | 1922248202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 7960088-1205) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY R1094) |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2023-11-27 |