| NPI | 1982725131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 231244) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: MA 231244) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2021-11-29 |