| NPI | 1952339814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 44444-20) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: WI 44444) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2025-05-20 |