| NPI | 1184759797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N7624) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01062575A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A115666) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2023-02-15 |