| NPI | 1952797839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 32208) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX S5850) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2025-10-20 |