| NPI | 1164487864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR C-5273) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR C5273) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2012-03-30 |