| NPI | 1043536576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME129702) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2025-00400) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 51925) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01071833A) | |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2025-10-02 |