| NPI | 1235352923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 72075) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 063419) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 41561) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2024-09-17 |