| NPI | 1225016835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 46406) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 223452) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01061964A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2008-0142) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2023-03-31 |