| NPI | 1124021365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology Nuclear Radiology (Licence: TN 29116) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: TN 29116) |
| 2085N0904X Radiology Nuclear Radiology (Licence: MS 15289) | |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2016-08-03 |