| NPI | 1992232268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A176005) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ r76387) |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2022-06-08 |