| NPI | 1174840482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 83832) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 02003909A) |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2022-08-05 |