| NPI | 1235114505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD9383) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME37447) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2010-12-10 |