| NPI | 1043522311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 52466) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS T-2329) |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2021-03-03 |