| NPI | 1235164625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101281554) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01053055A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 35713) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2024-05-07 |