| NPI | 1982132544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2022-02692) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 91913) |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2024-11-12 |