| NPI | 1023245537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 71658) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 251702) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 049181) | |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2024-08-13 |