| NPI | 1124286737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N7944) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01066621A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-7073) | |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2022-08-29 |